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General NPI Number Information
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NPI Number | 1346859816
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Entity Type | Organization
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Legal Business Name | ANDREA L. FISHER OD
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 4693 LIBERTY AVE
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City | VERMILION
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State | OH
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Zip | 44089-3242
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Country | US
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Telephone | 440-714-1901
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Fax |
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Provider Business Mailing Address
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Address Line | 6171 E MEADOW FARM LN
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City | LORAIN
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State | OH
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Zip | 44053-1893
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Country | US
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Telephone | 440-714-1901
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | ANDREA FISHER
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Credential | OD
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Telephone | 440-714-1901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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